More than 2,000 Kaiser mental health clinicians are striking in Northern California and Hawai’i
In what is now the longest mental health strike in U.S. history, more than 2,000 NUHW-represented mental health therapists, psychologists, social workers and chemical dependency counselors are walking picket lines every day in Northern California and Hawai’i to make Kaiser Permanente fix a mental healthcare system so broken that patients wait months to start therapy.
“Kaiser’s mental health care system is falling apart,” said Kenneth Rogers, a psychologist for Kaiser in Sacramento. “We don’t have enough hours in the day to see patients and do all the preparation and follow-up work that goes into every appointment. Patients are suffering and therapists are leaving in droves, while Kaiser sits on billions of dollars refusing to fix the problem.”
Clinicians in Northern California started striking on August 15, and their counterparts in Hawai’i joined them on Aug. 29. Kaiser has so far refused to engage in bargaining after offering contract proposals that didn’t address the core issues of increasing staffing and access to care.
Substandard Mental Health Care
Kaiser has a long history of violating mental health access laws and clinical standards. It has been fined by state regulators for denying members timely access to care, sued by local prosecutors and is now facing a new state investigation following a sharp rise in patient complaints last year. In response to concerns from Kaiser psychologists, the American Psychological Society told state regulators that Kaiser’s appointment wait times were the worst it had seen.
Access to mental health care for Kaiser patients has further deteriorated during the pandemic. Rates of depression and anxiety have soared, but Kaiser staffs just 1 full-time equivalent therapist for every 2,600 members in Northern California despite having reported an $8.1 billion net profit last year. Saddled with unrelenting caseloads that leave patients routinely waiting four-to-eight weeks between therapy appointments in violation of a new state law that requires follow-up appointments be provided within 10 business days, therapists are leaving Kaiser at a record rate.
Access issues are even worse in Hawai’i, where Kaiser has just 57 mental health workers, including several nurses and medical social workers, caring for 266,000 members.
“It’s never been harder for Kaiser patients to access mental health care, and Kaiser’s proposals at the bargaining table would make things even worse,” said Darah Wallsten, a clinical psychologist at Kaiser’s Hilo Clinic. “The only choice we have at this point is to strike for as long as it takes to make Kaiser meet the needs of our patients and stop understaffing our clinics.”
Thousands of appointments illegally canceled
Internal emails obtained from Kaiser managers show that the HMO is illegally canceling thousands of appointments in California in violation of state law and refusing to perform checks-ins on patients who are at risk of suicide or admit them into intensive outpatient treatment programs. After receiving complaints from 19 patients in the first week of the strike in California, the Department of Managed Health Care launched an investigation into the mass cancellations and denials of care at Kaiser. In Hawai’i, NUHW has filed a similar complaint over rampant cancellations in response to the strike.
Sticking points are over staffing and patient access to care
During bargaining before the strike began in California, clinicians accepted a wage offer from Kaiser, but the HMO rejected a comprehensive settlement proposal that included provisions aimed at making Kaiser significantly increase staffing and sharply reduce appointment wait times.
“We can’t in good conscience agree to a proposal that doesn’t fundamentally change Kaiser’s approach to mental health care,” said Chelsea Wise-Diangson, a therapist for Kaiser in Santa Clara. “Our patients’ health and our professional ethics are at stake. We need Kaiser to provide us with sufficient staffing and resources to help our patients get better, just like it does for its doctors providing medical care.”
In Hawai’i, Kaiser has singled out its mental health clinicians for wage freezes and retirement benefit cuts that would make it harder for Kaiser to hire new therapists and keep the ones it still has.
“Kaiser couldn’t be more hypocritical when it comes to mental health care,” NUHW President Sal Rosselli said. “When it gets in trouble for violating mental health access standards, it pledges to boost staffing, but then it turns around and demands cuts that will make its clinics more understaffed than ever.”